{ "cells": [ { "cell_type": "markdown", "metadata": {}, "source": [ "(apollo-dionysus)=\n", "# Apollo & Dionysus\n", " \n", "\n", "\n", "\n", "\n", "\n", "\n", "
\n", "\n", "\n", "\n", "United States | [Losing count](https://www.economist.com/united-states/2025/03/30/doge-comes-for-the-data-wonks) \n", "## DOGE comes for the data wonks\n", "America may soon be unable to measure itself properly\n", "\n", "\n", "\n", "Mar 30th 2025|New York\n", "\n", "FOR NEARLY three decades the federal government has painstakingly surveyed tens of thousands of Americans each year about their health. Door-knockers collect data on the financial toll of chronic conditions like obesity and asthma, and probe the exact doses of medications sufferers take. The result, known as the Medical Expenditure Panel Survey (MEPS), is the single most comprehensive, nationally representative portrait of American health care, a balkanised and unwieldy $5trn industry that accounts for some 17% of GDP.\n", "\n", "MEPS is part of a largely hidden infrastructure of government statistics collection now in the crosshairs of the Department of Government Efficiency (DOGE). In mid-March officials at a unit of the Department of Health and Human Services (HHS) that runs the survey told employees that DOGE had slated them for an 80-90% reduction in staff and that this would “not be a negotiation”. Since then scores of researchers have taken voluntary buyouts. Those left behind worry about the integrity of MEPS. “Very unclear whether or how we can put on MEPS” with roughly half of the staff leaving, one said. On March 27th, the health secretary, Robert F. Kennedy junior, announced an overall reduction of 10,000 personnel at the department, in addition to those who took buyouts.\n", "\n", "```{raw} html\n", "\n", "\n", "History is a fractal unfolding of entropy and order, a ceaseless churn wherein civilizations & belief-systems rise on the back of extracted resources, only to collapse under the weight of their own complexity
\n", "\n", " Cosmology, Geology, Biology, Ecology, Symbiotology, Teleology\n", "\n", "\n", "Even so, America’s system of statistics research is overly analogue and needs modernising. “Using surveys as the main source of information is just not working” because it is too slow and suffers from declining rates of participation, says Julia Lane, an economist at New York University. In a world where the economy shifts by the day, the lags in traditional surveys—whose results can take weeks or even years to refine and publish—are unsatisfactory. One practical reform DOGE might encourage is better integration of administrative data such as tax records and social-security filings which often capture the entire population and are collected as a matter of course.\n", "\n", "As in so many other areas, however, DOGE’s sledgehammer is more likely to cause harm than to achieve improvements. And for all its clunkiness, America’s current system manages a spectacular feat. From Inuits in remote corners of Alaska to Spanish-speakers in the Bronx, it measures the country and its inhabitants remarkably well, given that the population is highly diverse and spread out over 4m square miles. Each month surveys from the federal government reach about 1.5m people, a number roughly equivalent to the population of Hawaii or West Virginia.\n", "\n", "The MEPS case suggests how DOGE’s haphazard cuts risk upending an elaborate ecosystem. Contracted employees at Westat, a private research firm, conduct the survey for the Agency for Healthcare Research and Quality (AHRQ), a part of HHS, and the National Centre for Health Statistics, a part of the Centres for Disease Control and Prevention. Specialised field staff go door to door collecting sensitive personal health and financial data from a sample of Americans. Those data are then combined with information from the respondents’ medical providers. Experts at AHRQ turn this into a nationally representative sample through data-weighting and imputation.\n", "\n", " \n", "\n", "```{raw} html\n", "\n", "\n", "\n", "
\n", " Attention
\n", " Nonself vs. Self
\n", " Identity Negotiation
\n", " Salience, Expand, Reweight, Prune, Networkxw
\n", " — Yours Truly\n", "